Maternal vitamin D supplementation to optimize the vitamin D status of breastfed infants

Abstract

Vitamin D supplementation of breastfed infants is recommended because breast milk levels are low. We sought to determine if maternal supplementation would increase breast milk levels to achieve sufficiency in their infants. Forty mothers with exclusively breastfed infants were randomized to receive oral cholecalciferol (vitamin D3) 5000 IU/d for 28 days or 150,000 IU once. Maternal serum, breast milk and urine were collected on days 0, 1, 3, 7, 14 and 28 and infant serum on days 0 and 28. In mothers receiving daily vitamin D, serum and breast milk cholecalciferol attained steady levels of 18 and 8 ng/ml, respectively, from day 3 through 28. In mothers given the single dose, serum and breast milk cholecalciferol peaked at 160 and 40 ng/ml, respectively at day 1, before rapidly declining. Breast milk and maternal serum cholecalciferol were related (r=0.87). Infant serum 25OHD (mean±SD) increased from 17±13 to 39±6 ng/ml in the single dose group and from 16±12 to 39±12 ng/ml in the daily dose group (P= 0.88). All infants achieved sufficient 25OHD serum levels (≥20ng/mL). This study suggests that maternal supplementation can achieve sufficient infant serum levels of 25OHD via breastfeeding. A large single dose of vitamin D was equivalent to daily dosing for optimizing infant vitamin D status. This research was funded by the National Center for Research Resources and Mayo Clinic.Grant Funding Source: NCRR and Mayo Clinic